Atrial fibrillation

Question 1

Most common sustained arrhythmia

Answer 1

AF

Question 2

Prevalence of AF is > 95% in px > ___ of age

Answer 2

60

Question 3

AF is the cause of ___% of stroke

Answer 3

25%

Question 4

Define Paroxysmal AF

Answer 4

7 days or less

Question 5

Define Long standing AF

Answer 5

> 1 yr

Question 5

Define Persistent AF

Answer 5

Occurs continuously > 7 days < 1 yr

Question 6

Thrombus formation primarily occurs in ____ in AF px

Answer 6

left atrial appendage

Question 7

Define stiff left atrial syndrome

Answer 7

non compliant fibrotic LA with elevated LA filling pressures, volume overload, and CHF

Question 8

If presenting episode of AF is > ___ hrs or if episode duration is unkown, there is risk of precipitating thrombotic complication through cardioversion

Answer 8

48

Question 9

Duration of anticoagulation before cardioversion when duration of AF > 48 hrs or unknown

Answer 9

3 weeks before and at least 4 weeks after

Question 10

Definition of adequate HR control in AF

Answer 10

Resting HR < 80 that increases to < 100 bpm

Question 11

Standard dose and reduced dose of Dabigatran

Answer 11

150 mg bid
110 mg bid

Question 12

Standard dose and reduced dose of Rivaroxaban

Answer 12

20 qd
15 qd

Question 13

Standard dose and reduced dose of Apixaban

Answer 13

5 mg bid
2.5 mg bid

Question 14

Standard dose and reduced dose of Edoxaban

Answer 14

60 mg qd
30 mf qd

Question 15

Dose reduction criteria of Dabigatran

Answer 15

Age >= 80 , concomitant use of Verapamil and inc bleeding risk

Question 16

Dose reduction criteria of Apixaban

Answer 16

At least 2 of 3
Age >= 80
BW <= 60 kg
Serum Crea >= 1.5 mg/dl

Question 16

Dose reduction criteria of Rivaroxaban

Answer 16

Crea clearance 15-49 ml/min

Question 16

Dose reduction criteria of Edoxaban

Answer 16

Any of the ff
Crea clearance 30-50 ml/min
BW <= 60 kg
concomitant use of dronedarone, cyclosporine, erythromycin and ketoconazole

(mnemonic: eDECKxaban)
Dronedarone-Erythromycin-Cylosporine-Ketoconazole

Question 17

In paroxysmal AF sinus rhythm is maintained > 1 yr after single ablation procedure in ___ % of px and > ___ % of px with multiple procedures

Answer 17

70%, 90%